8-Attachment B-Bidders Cert.pdf
PDF 135 KB Posted
- Attached to
- 1st Floor Pharmacy Renovation
- Solicitation number
- PROJ-25-098
- Issued by
- Volusia County, Florida
About this file
This is a bidder's certification form for Halifax Health Medical Center in Florida, specifically Attachment B for ITB # PROJ-25-098. The document serves as a required certification that bidders must complete and submit as part of their bid submission process, though the specific products or services being procured are not identified in this attachment. The form requires bidders to certify compliance with various legal and ethical requirements, including receipt of complete bid papers, anti-collusion practices, equal opportunity employment compliance, sexual harassment policy adoption, and adherence to all federal, state, and local regulations.
The certification form includes fields for company information, authorized official signatures, and contact details, but does not contain pricing terms, set-aside provisions, or funding information as this is strictly a compliance certification document. The second page includes a notarized tax certification section where bidders must swear under oath that they are not barred from contracting with Florida local government units due to tax delinquencies with the Florida Department of Revenue, unless such taxes are being contested through proper legal procedures. Both sections require notarization and official signatures from authorized company representatives.
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Text version
ATTACHMENT B
HALIFAX HEALTH MEDICAL CENTER
BIDDER’S CERTIFICATION
ITB # PROJ-25-098
I/We hereby certify that:
A. A complete set of bid papers, as intended, has been received, and I/We will abide by the contents and/or information received and/or contained herein.
B. I/We have not entered into any collusion or other unethical practices with any person, firm, or employee of the District which would in any way be construed as unethical practice.
C. I/We comply with all current federal, state and local laws, statutes, rules, and regulations referencing equal opportunity employment practices.
D. I/We have adopted a written sexual harassment policy which is in accordance with the requirements of federal, state and local laws, regulations and policies.
E. I/We will abide by all other federal, state and local codes, rules, regulations, ordinances and statutes.
COMPANY NAME
ADDRESS
DISTRICT/STATE/ZIP CODE
NAME OF CORPORATE/COMPANY OFFICIAL
(PLEASE TYPE OR PRINT CLEARLY)
TITLE
AUTHORIZED OFFICIAL SIGNATURE
DATE
TELEPHONE ( )
HALIFAX HEALTH MEDICAL CENTER
STATE OF FLORIDA
ITB # PROJ-25-098
COUNTY OF
BIDDER’S TAX CERTIFICATION
(BIDDER’S EXECUTING OFFICER), being first duly sworn on oath, deposes and states that all statements made herein are made on behalf of the Bidder, that this respondent is authorized to make them and that the statements contained herein are true and correct. Bidder deposes, states and certifies that Bidder is not barred from contracting with any unit of local government in the State of Florida as result of a delinquency in payment of any tax administered by the Florida Department of Revenue unless Bidder is contesting, in accordance with the procedures established by the appropriate statute, its liability for the tax or the amount of the tax.
DATED this day of , 2025.
By (Bidder’s Executing Officer)
(Name of Bidder’s Executing Officer)
(Title)
ATTEST/WITNESS:
By
Title
Subscribed and sworn to before me this day of , 2025.
Notary Public
(SEAL)
File details come from the government source that posted it. Updated .